Report Calls for ‘Vulnerability Lens’ in Federal Legislation for Physician-Assisted Death

TORONTO, ON -- A report launched today calls on the federal
government to take an evidence-based approach to designing safeguards to
protect vulnerable persons in the system for physician-assisted death. Released by the Canadian Association for
Community Living (CACL), the report on "Assessing Vulnerability in a system for
physician-assisted death in Canada" draws on extensive research on safeguards
and risks of vulnerability in systems for physician-assisted death in other
jurisdictions.

Based on evidence from an extensive review of scientific
studies, the report recommends that requests for physician-assisted death be
considered through a ‘vulnerability lens’ to discern: risk of suicidality; predominance of
psychosocial suffering and unmet needs; dynamics of undue influence or coercion
that could motivate the request; personal resilience to vulnerability; and, the
extent to which a person is potentially vulnerable or actually vulnerable.

Joy Bacon, CACL President, said "This research
report also raises very serious concerns that in the current health care system
in Canada it would not be possible to implement a consistent, pan-Canadian
approach to vulnerability assessment."

The research points to four main limitations in the current system: incomplete and
inconsistent statutory obligations for health care consent and to assure
absence of coercion, inducement
and undue influence; varying health profession guidelines for informed consent
and response to vulnerable persons; limitations of relying solely on physicians
to assess vulnerability; and lack of proven tools and protocols to assess and
respond to vulnerability.

To ensure a pan-Canadian approach to safeguarding
vulnerable persons the report recommends federal legislation amending the Criminal Code to: 1) establish a national standard
for obtaining informed consent for the procedure, requiring the adult’s
decision to be non-ambivalent, voluntary and free of undue influence or
coercion; 2) require vulnerability
assessment in response to each request; and, given that the Supreme
Court legalized physician-assisted suicide as an exception to the Criminal Code;3) mandate prior independent
review and authorization of requests.

Michael Bach, CACL Executive Vice-President,
said: "The Supreme Court of Canada declared
a constitutional requirement that the system must balance access with
protecting persons who are vulnerable to being induced to commit suicide. This is the first report to provide an
evidence base for how that balance can be accomplished in a way that protects
vulnerable Canadians. We are hopeful
that the federal government will be guided by the evidence in presenting its
proposed safeguards to Parliament."